Management of Breech Presentation GTG

Question 1

What is the reduction in perinatal mortality of ELCS Vs planned VD?

Answer 1

2-5% risk reduction

Absolute risk of perinatal mortality with
ELCS 0.5/100
VD of cephalic 1/1000
VD of breech is 2/1000

Question 2

Risk of EMCS with vaignal breech

Answer 2

40%

Question 3

Women at higher risk during vaginal breech

Answer 3

Hyperextended neck
High EFW >3.8
Low EFW <10th
Footling
AN fetal compromise

Question 4

What % of breech not Dx until labour

Answer 4

25%

Question 5

Can ARM be offered to vaignal breech?

Answer 5

No

Question 6

Can oxytocin be offered?

Answer 6

Only is epidural and contractions <4/10

Question 7

When to offer CS?

Answer 7

Slow progress
Passive 2nd stage and breech not viable within 2 hours
EFM abnormal before 2nd stage

Question 8

When to encourage pushing?

Answer 8

When breech is viable, once buttocks based perineum cord compression common

Question 9

When to assist delivery?

Answer 9

Lack tone/colour
> 5 mins from buttocks to head
>3 mins umbilicus to head

Question 10

Where to cut cervix if entrapment of head

Answer 10

2,6,10 o clock